[Outcomes of severe primary fetal hydrothorax treated by prenatal intervention]

Objective: To investigate the effect of intrauterine intervention on severe primary fetal hydrothorax. Methods: Twelve cases with severe fetal primary hydrothorax who underwent prenatal intervention from January 2014 to December 2017 in Guangdong Women and Children Hospital were retrospectively reviewed. Results: The median gestational age of prenatal diagnosis was 30.8 weeks (24.0-33.0 weeks) . All cases were excluded congenital chromosomal abnormalities by prenatal diagnosis, and had no complications of pregnancy during prenatal diagnosis and had hydrothorax. Three cases (3/12) were right hydrothorax, the other 9 cases (9/12) were bilateral. Thoracoamniotic shunting was performed in 7 cases (7/12) . Thoracentesis was performed in 5 cases (5/12) , and the hydrothorax reappeared soon after operation in 4 cases, shunt placement was performed again. The hydrothorax was dissolved in 2 cases, released in 6 cases.Tube falling off occurred in 1 case,treatment was abandoned in 1 case and intrauterine fetal death happened in 1 case, and 1 case wasn't rechecked by ultrasonic due to premature birth following thoracentesis. In 10 cases who had deliveries, 5 newborns (5/10) were premature, 6 newborns (6/10) underwent assisted mechanical ventilation, 8 newborns (8/10) underwent thoracic close drainage, all of them were discharged when hydrothorax resolved. Conclusions: Antenatal intervention may improve the chance of survival in severe primary fetal hydrothorax. Thoracoamniotic shunting is the first-choice for the primary severe fetal hydrothorax.

Effect of two recombinant Trichinella spiralis serine protease inhibitors on TNBS-induced experimental colitis of mice

Inflammatory bowel disease (IBD), which includes ulcerative colitis and Crohn's disease (CD), is a chronic autoimmune disease. Parasitic infections and their products have been shown to have protective effects on autoimmune diseases, including IBD. In this experiment, 96 male BALB/c mice aged 6-8 weeks were divided randomly into two large groups: prevention and therapy. The changes in the various indicators of colitis were detected to demonstrate that Trichinella spiralis serine protease inhibitors can relieve the inflammatory severity of 2,4,6-trinitrobenzenesulphonic acid solution (TNBS)-induced colitis and to explore possible immunological mechanisms. Results showed that the disease activity index (DAI) score, myeloperoxidase (MPO) activity, macroscopic and microscopic damage degrees of colon all decreased significantly, interferon (IFN)-γ expression decreased, interleukin (IL)-4 expression increased, nuclear factor kappa B (NF)-κB expression decreased and the percentage of CD4⁺ CD25⁺ forkhead box protein 3 (FoxP3⁺ ) regulatory T cells (T_reg ) cells in the spleen. MLN increased significantly compared to the phosphate-buffered saline (PBS)/2,4,6-trinitrobenzenesulphonic acid solution (TNB) group. We found the same results with the T. spiralis Kazal-type serine protease inhibitors (TsKaSPI)+TNBS and TsAdSPI+TNBS groups in the large prevention group and the large therapy group, compared to the TNBS+PBS group with the TNBS+TsKaSPI and TNBS+TsAdSPI groups. Immunization with TsKaSPI and TsAdSPI on the CD models showed an intervention effect, possibly because TsKaSPI and TsAdSPI induced a T helper type 2 (Th2)-type immune response and balanced the TNBS-induced Th1-type immune response.

[Two-year clinical and radiological outcomes of minimally invasive surgery for severe adult degenerative scoliosis]

Objectives: To evaluate the efficacy of restoring the balance in the coronal and sagittal planes and to evaluate clinical outcomes in the treatment of severe adult degenerative scoliosis patients using staged lateral lumbar interbody fusion (LLIF) and percutaneous transpedicle screw fixation (pTSF). Methods: A retrospective analysis was made on 13 patients with severe adult degenerative scoliosis treated with staged surgery in Ruijin Hospital between May, 2014 and July, 2015. The operation data were collected, including operation time, estimated blood loss, and complications. Preoperative and postoperative standing anteroposterior and lateral lumbar radiographs were obtained by EOS image system in all patients for measurement of sagittal and coronal plane alignment. All patients were available for at least 24 months of following-up (18-32 months). Paired sample t test was used to compare the parameters of each group pre- and post-operation. Results: All of the 13 patients received LLIF with staged transpedicle screw fixation. Mean operation time was (231±48) minutes and (155±33) minutes for two-stage surgery. Mean blood loss was (253±80) ml during one-stage LLIF surgery and (326±99) ml during two-stage pTSF surgery. The interval between two surgical procedures was from 7 to 42 days (mean 14 days). In the coronal plane, the mean Cobb angle of curves was 43.1°±7.3° preoperatively, and it was 11.4°±4.0°after one-stage LLIF (t=10.16, P<0.001) and 5.5°±1.9° after two-stage pTSF (t=6.14, P<0.001). In the sagittal plane, lumbar lordosis (LL) changed after each procedure was as follows: LLIF from 16.8°±8.4° to 30.1°±6.8° (t=5.21, P<0.001) and PSF to 37.1°±4.0° (t=5.04, P<0.001). Sagittal vertical axis (SVA) was reduced from (10.5±2.4) cm to (5.3±2.1) cm after one-stage LLIF (t=8.52, P<0.001) and to (3.1±1.5) cm after two-stage pTSF (t=5.51, P<0.001). In the spino-pelvic parameter, pelvic incidence(PI)-LL mismatch decreased from 33.6°±9.6° to 17.8°±4.5° (t=5.31, P<0.001) after LLIF and to 9.9°±3.7° after pTSF (t=4.68, P<0.001). The visual analogue scale (VAS) of low back pain and leg pain and the Oswestry dability Index (ODI) improved significantly at the last follow-up (t=10.42, 8.94, 19.20, all P<0.01). Conclusions: LLIF significantly improves segmental and coronal plane alignment in patients with degenerative lumbar scoliosis, and these patients can be effectively corrected by staged minimally invasive surgery.

An instrument for studying granular media in low-gravity environment

A new experimental facility has been designed and constructed to study driven granular media in a low-gravity environment. This versatile instrument, fully automatized, with a modular design based on several interchangeable experimental cells, allows us to investigate research topics ranging from dilute to dense regimes of granular media such as granular gas, segregation, convection, sound propagation, jamming, and rheology-all without the disturbance by gravitational stresses active on Earth. Here, we present the main parameters, protocols, and performance characteristics of the instrument. The current scientific objectives are then briefly described and, as a proof of concept, some first selected results obtained in low gravity during parabolic flight campaigns are presented.

Randomised clinical trial: Tong-Xie-Yao-Fang granules versus placebo for patients with diarrhoea-predominant irritable bowel syndrome

BACKGROUND

Tong-Xie-Yao-Fang (TXYF) is a Chinese herbal formula for treating chronic diarrhoea accompanied by abdominal pain. The results were inconsistent in previous trials examining its effect.

AIM

To study the efficacy of TXYF granules for treating diarrhoea-predominant irritable bowel syndrome (IBS-D).

METHODS

We performed a double-blind, placebo-controlled randomised trial and enrolled 160 participants with IBS-D. The participants had VAS scores ≥3 cm in IBS-D global symptoms and ≥2 days in a week with abdominal pain and loose stools (Bristol score 5, 6 or 7). They were randomly assigned to received TXYF or placebo during a treatment period of 4 weeks, and they were followed up for 8 weeks after treatment. The primary outcome was adequate relief of IBS-D global symptoms for at least 2 of 4 weeks during weeks 1-4. Secondary outcomes included mean weekly VAS scores of IBS-D major symptoms, mean weekly stool frequency, mean weekly Bristol score, and adverse events.

RESULTS

155 of 160 patients completed the trial. We found a significantly higher rate of adequate relief of global symptoms in TXFY group during weeks 1 to 4 (57.5% vs 37.5%, χ² = 5.6391, P = 0.017); logistic regression analysis showed a similar result (OR 2.2, 95% CI 1.2-4.4, P = 0.016). Most of the secondary outcomes showed superiority of TXYF over placebo in weekly assessment from week 3 to week 7. The adverse event rate was low in both groups (3.8% vs 3.8%, P = 1.000).

CONCLUSION

During a 4 week trial, TXFY granules were superior to placebo in controlling symptoms of IBS-D.

Design, synthesis and biological activities of 2,3-dihydroquinazolin-4(1H)-one derivatives as TRPM2 inhibitors

Transient receptor potential melastatin 2 (TRPM2), a Ca²⁺-permeable cationic channel, plays critical roles in insulin release, cytokine production, body temperature regulation and cell death as a reactive oxygen species (ROS) and temperature sensor. However, few TRPM2 inhibitors have been reported, especially TRP-subtype selective inhibitors, which hampers the investigation and validation of TRPM2 as a drug target. To discover novel TRPM2 inhibitors, 3D similarity-based virtual screening method was employed, by which 2,3-dihydroquinazolin-4(1H)-one derivative H1 was identified as a TRPM2 inhibitor. A series of novel 2,3-dihydroquinazolin-4(1H)-one derivatives were subsequently synthesized and characterized. Their inhibitory activities against the TRPM2 channel were evaluated by calcium imaging and electrophysiology approaches. Some of the compounds exhibited significant inhibitory activity, especially D9 which showed an IC₅₀ of 3.7 μM against TRPM2 and did not affect the TRPM8 channel. The summarized structure-activity relationship (SAR) provides valuable insights for further development of specific TRPM2 targeted inhibitors.

Cstf2t Regulates expression of histones and histone-like proteins in male germ cells

Formation of the 3' ends of mature mRNAs requires recognition of the correct site within the last exon, cleavage of the nascent pre-mRNA, and, for most mRNAs, addition of a poly(A) tail. Several factors are involved in recognition of the correct 3'-end site. The cleavage stimulation factor (CstF) has three subunits, CstF-50 (gene symbol Cstf1), CstF-64 (Cstf2), and CstF-77 (Cstf3). Of these, CstF-64 is the RNA-binding subunit that interacts with the pre-mRNA downstream of the cleavage site. In male germ cells where CstF-64 is not expressed, a paralog, τCstF-64 (gene symbol Cstf2t) assumes its functions. Accordingly, Cstf2t knockout (Cstf2t^-/- ) mice exhibit male infertility due to defective development of spermatocytes and spermatids. To discover differentially expressed genes responsive to τCstF-64, we performed RNA-Seq in seminiferous tubules from wild-type and Cstf2t^-/- mice, and found that several histone and histone-like mRNAs were reduced in Cstf2t^-/- mice. We further observed delayed accumulation of the testis-specific histone, H1fnt (formerly, H1t2 or Hanp1) in Cstf2t^-/- mice. High-throughput sequence analysis of polyadenylation sites (A-seq) indicated reduced use of polyadenylation sites within a cluster downstream of H1fnt in knockout mice. However, high-throughput sequencing of RNA isolated by cross-linking immunoprecipitation (HITS-CLIP) was not consistent with a direct role of τCstF-64 in polyadenylation of H1fnt. These findings together suggest that the τCstF-64 may control other reproductive functions that are not directly linked to the formation of 3' ends of mature polyadenylated mRNAs during male germ cell formation.

miR-26a suppresses osteosarcoma migration and invasion by directly targeting HMGA1

Osteosarcoma (OS) is identified as the most commonly diagnosed malignant cancer of bone, and has approximately three million new cases annually. miR-26a plays an important role in the development of various types of cancer. We investigated whether miR-26a can regulate the migration and invasion of OS by targeting high-mobility group A1 HMGA1. Western blot analysis was used to identify the changes of protein levels. Reverse transcription-quantitative PCR was used to test expression levels of genes and miR-26a. Luciferase reporter assay was used to test the specific target gene of miR-26a. Transwell assay was employed to determine the migration and invasion of OS cell lines. In the present study, miRNA-26a was frequently downregulated in OS tissues and cells. Overexpression of miR-26a inhibited cell migration and invasion in vitro. In addition, miR-26a downregulated HMGA1 by targeting its 3′-UTR and knockdown of HMGA1 significantly suppressed the migration and invasion of two osteosarcoma cell lines in vitro. miR-26a suppressed the migration and invasion of OS cells by targeting HMGA1, suggesting that miR-26a/HMGA1 axis provides a new prospective therapeutic strategy for OS.

The glycosyltransferase ST6Gal-I is enriched in cancer stem-like cells in colorectal carcinoma and contributes to their chemo-resistance

PURPOSE

Presence of cancer stem cells (CSCs) contributes to tumor outgrowth, chemo-resistance and relapse in some cancers including colorectal carcinoma (CRC). The current characterization methods of CSCs in CRC only allows enrichment of CSCs but not their purification. Recent reports showed that ST6 beta-galactoside alpha-2,6-sialyltransferase 1 (ST6Gal-I) plays an essential role in protecting tumor cells against harsh environment like oxidative stress and nutrient deprivation. Therefore, whether ST6Gal-I may be highly expressed in CSCs or whether it may enhance resistance of tumor cells to chemotherapy deserves exploration.

METHOD

ST6Gal-I levels were determined in CRC specimens, compared to paired normal colorectal tissue, and examined in CD133+ vs CD133- CRC cells, and CD44+ vs CD44- CRC cells. ST6Gal-I levels and their association with patient survival were examined. In vivo, 2 CRC cell lines Caco-2 and SW48 were transduced with two lentiviruses, one lentivirus carrying a green fluorescent protein reporter and a luciferase reporter under a cytomegalovirus promoter to allow tracing tumor cells by both fluorescence and luciferase activity, and one lentivirus carrying a nuclear red fluorescent protein under the control of ST6Gal-I promoter to allow separation of ST6Gal-I+ vs ST6Gal-I- CRC cells. Tumor sphere formation, resistance to fluorouracil-induced apoptosis, and frequency of tumor formation after serial adoptive transplantation were done on ST6Gal-I+ vs ST6Gal-I- CRC cells.

RESULT

ST6Gal-I levels were significantly upregulated in clinically obtained CRC specimens, compared to paired normal colorectal tissue. Poorer patient survival was detected in ST6Gal-I-high CRC, compared to ST6Gal-I-low subjects. Higher levels of ST6Gal-I were detected in CD133+ CRC cells than CD133- CRC cells, and in CD44+ CRC cells than in CD44- CRC cells. Compared to ST6Gal-I- CRC cells, ST6Gal-I+ CRC cells generated significantly more tumor spheres in culture, were more resistant to fluorouracil-induced apoptosis likely through upregulating cell autophagy, and generated tumor more frequently after serial adoptive transplantation.

CONCLUSION

ST6Gal-I may be highly expressed in the cancer stem-like cells in CRC and enhances cancer cell resistance to chemotherapy.

Selective inhibition of TRPM2 channel by two novel synthesized ADPR analogues

Transient receptor potential melastatin-2 (TRPM2) channel critical for monitoring internal body temperature is implicated in the pathological processes such as neurodegeneration. However, lacking selective and potent TRPM2 inhibitors impedes investigation and validation of the channel as a drug target. To discover novel and selective TRPM2 inhibitors, a series of adenosine 5'-diphosphoribose analogues were synthesized, and their activities and selectivity were evaluated. Whole-cell patch-clamp recordings were employed for screen and evaluation of synthesized compounds. Two compounds, 7i and 8a, were identified as TRPM2 inhibitors with IC50 of 5.7 and 5.4 μm, respectively. Both 7i and 8a inhibited TRPM2 current without affecting TRPM7, TRPM8, TRPV1 and TRPV3. These two TRPM2 inhibitors can serve as new pharmacological tools for further investigation and validation of TRPM2 channel as a drug target, and the summarized structure-activity relationship (SAR) may also provide insights into further improving existing inhibitors as potential lead compounds.

Nursing Information Systems

Objective: In order to ensure the successful implementation of a nursing information system (NIS), nurses and nursing students must be adequately trained. In order to do this effectively, it is essential to understand their training needs. This study focuses on the training needs of nursing students in particular through the identification of the usage problems they encounter. Usability testing, which involves observing users’ interaction with an NIS, overcomes the deficiencies of traditional approaches of training needs analysis such as interviewand survey. The study applied usability test to assess training needs of nursing students to learn to use a specific NIS, the “Care Planning Assessment Tool” (CPAT).

Methods: An experiment in which novice CPAT users were expected to learn to use the software through task-based exploration was conducted. Eight nursing undergraduate students who had never used the software were recruited. Participants’ interactionswith the system were captured by screen capture software. Meanwhile, participants’ “think aloud” verbal expression of their usage problems was audio-taped.

Results: A coding schemewas used in analysing the captured audio and video data. Ten common usage problems were identified. From these problems, three areas of knowledge gap that this cohort of novice users experienced were identified.

Conclusion: The training needs of nursing students learning to use an NIS was conceptualised in a model consisting of three types of knowledge, i.e. computer skills, knowledge about the NIS and knowledge about procedure of nursing documentation. The knowledge gap must be filled in order to ensure effective training.